DAMERON HOSPITAL ASSOCIATION: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- DAMERON HOSPITAL ASSOCIATION (EIN 94-1201197)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2016-05-04
- IRS object ID
- 201631259349300043
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-04T11:21:16-05:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Moss Adams LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3121 W March Ln Ste 200 | AddressLine1Txt |
| City | Stockton | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 952192367 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 941201197 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dameron Hospital Association | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DAME | BusinessNameControlTxt |
| Phone | 2099445550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 West Acacia Street | AddressLine1Txt |
| City | Stockton | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95203 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lorraine Auerbach | PersonNm |
| Person Title | President/CEO | PersonTitleTxt |
| Phone | 2099445550 | PhoneNum |
| Signature | 2016-05-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Tracy S Paglia | PreparerPersonNm |
| PTIN | P00366884 | PTIN |
| Phone | 2099556100 | PhoneNum |
| Preparation | 2016-05-04 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Lorraine Auerbach | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 West Acacia Street | AddressLine1Txt |
| City | Stockton | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $206,362,682 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.dameronhospital.org | WebsiteAddressTxt |
| Type Of Organization Assoc | Yes (X) | TypeOfOrganizationAssocInd |
| Formation | 1912 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | We support physicians and our employees in providing quality care in a safe, caring environment. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 1130 | TotalEmployeeCnt |
| Total Volunteers | 60 | TotalVolunteersCnt |
| Total Gross UBI | $126,053 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $135,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $260 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $189,459,429 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $184,625,035 | CYProgramServiceRevenueAmt |
| PY Investment Income | $803,207 | PYInvestmentIncomeAmt |
| CY Investment Income | $219,715 | CYInvestmentIncomeAmt |
| PY Other Revenue | $77,152 | PYOtherRevenueAmt |
| CY Other Revenue | $175,722 | CYOtherRevenueAmt |
| PY Total Revenue | $190,474,788 | PYTotalRevenueAmt |
| CY Total Revenue | $185,020,732 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $92,388,352 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $87,162,772 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $110,738,792 | PYOtherExpensesAmt |
| CY Other Expenses | $97,861,095 | CYOtherExpensesAmt |
| PY Total Expenses | $203,127,144 | PYTotalExpensesAmt |
| CY Total Expenses | $185,023,867 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$12,652,356 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,135 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $152,203,396 | TotalAssetsBOYAmt |
| Total Assets EOY | $154,281,475 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $28,691,272 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $29,560,088 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $123,512,124 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $124,721,387 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | We support physicians and our employees in providing quality care in a safe, caring environment. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $169,087,248 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $184,595,880 | RevenueAmt |
| Desc | Dameron Hospital Association is a non-profit facility providing a full emergency and acute care.Dameron exists solely to serve the healthcare needs of the surrounding communities, providing advanced technology and state-of-the-art diagnostic and therapeudic equipment, as well as facilities for inpatient, outpatient and occupational patient care.Hospital services include cardiology, orthopedics, neonatology, bariatrics, emergency/urgent care, imaging services, occupational health care.Beginning with its founder, Dameron Hospital has continued an uncompromised approach to patient care and health care attitudes believing not only in serving the community but being a part of it. The hospital offers outreach and scholarship programs through young scrubs and preceptor programs for young nurses.The mission is to support the physicians and employees in providing quality patient care in a safe and caring environment. The vision is to be the hospital that physicians prefer, patients request and employees choose. | Desc |
| Total Program Service Expenses | $169,087,248 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 114 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1130 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lorraine Travis-Brown | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2099445550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 W Acacia St | AddressLine1Txt |
| City | Stockton | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95203 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Lorraine Auerbach | |||||||||
| President/CEO | 40.00 | Yes (X) | Yes (X) | $932,294 | $0 | $10,303 | |||
| William Trezza | |||||||||
| Chairman of the Board | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Dan Dixon | |||||||||
| Secretary/Treasurer | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Philip Ruhl | |||||||||
| Director | 10.00 | Yes (X) | $24,000 | $0 | $0 | ||||
| Robert Lawrence | |||||||||
| Director | 10.00 | Yes (X) | $0 | $0 | $0 | ||||
| Brian Martucci | |||||||||
| Director | 10.00 | Yes (X) | $0 | $0 | $0 | ||||
| Hon Ron A Northup | |||||||||
| Director | 10.00 | Yes (X) | $0 | $0 | $0 | ||||
| Gary Giannini | |||||||||
| Director | 10.00 | Yes (X) | $0 | $0 | $0 | ||||
| Elizabeth Propp | |||||||||
| VP of Finance, CFO | 40.00 | Yes (X) | $393,239 | $0 | $6,840 | ||||
| Michael Glasberg | |||||||||
| VP of Operations, COO | 40.00 | $350,313 | $0 | $5,459 | Yes (X) | ||||
| Janine Hawkins | |||||||||
| VP of Patient Care Services, CNO | 40.00 | $347,356 | $0 | $24,117 | Yes (X) | ||||
| David Kerrins | |||||||||
| VP of Information Services, CIO | 40.00 | $278,255 | $0 | $10,335 | Yes (X) | ||||
| Bradley Reinke | |||||||||
| VP of Medical Affairs, CMO | 40.00 | $259,600 | $0 | $0 | Yes (X) | ||||
| William Chase | |||||||||
| Director of Finance (Through 4/2014) | 40.00 | $282,863 | $0 | $5,499 | Yes (X) | ||||
| Chad Davis | |||||||||
| RN Manager - Surgery | 40.00 | $229,257 | $0 | $12,999 | Yes (X) | ||||
| Terrance Thomas | |||||||||
| Registered Nurse | 40.00 | $218,566 | $0 | $17,219 | Yes (X) | ||||
| Shawn Fillon | |||||||||
| Registered Nurse | 40.00 | $202,147 | $0 | $11,844 | Yes (X) | ||||
| Maria Villarreal | |||||||||
| Assistant Nurse Manager | 40.00 | $188,375 | $0 | $16,646 | Yes (X) | ||||
| Christopher Arismendi | |||||||||
| Former CEO (Through 10/2012) | 0.00 | $300,000 | $0 | $0 | Yes (X) | ||||
| Cyrus Dah | |||||||||
| Former CFO (Through 12/2012) | 0.00 | $162,500 | $0 | $0 | Yes (X) | ||||
| Nicholas Arismendi | |||||||||
| Former COO (Through 7/2013) | 0.00 | $243,750 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,412,515 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $121,261 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 280 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CPS LLC | |||||
| P O Box 638316 | Cincinnati | OH | 45263 | Pharmacy Services | $4,995,754 |
| Sound Physicians | |||||
| P O Box 742936 | Los Angeles | CA | 90074 | Hospitalist Services | $2,085,332 |
| Emerald Health Services | |||||
| 1801 W Olympic Blvd File 1471 | Pasadena | CA | 91199 | Registry Nurse Staffing | $1,483,573 |
| Rehab Practice Management | |||||
| 9364 Ansley Avenue | Brentwood | TN | 37027 | Rehabilitation Services | $1,148,427 |
| Dialysis & Pheresis Technologies | |||||
| P O Box 692312 | Stockton | CA | 95269 | Renal Dialysis Services | $787,784 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 23 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $260 | AllOtherContributionsAmt |
| Total Contributions | $260 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Rev. | 621110 | $102,439,693 | $102,439,693 |
| Medical/Medicare Pymts | 621110 | $58,540,234 | $58,540,234 |
| Hospital Fee | 621110 | $22,069,064 | $22,069,064 |
| Cafeteria | 722210 | $941,510 | $941,510 |
| Rebates/Refunds | 621110 | $174,643 | $174,643 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $459,891 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $459,891 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $184,625,035 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,310,779 | TotalRevenueColumnAmt |
| Exclusion | $1,310,779 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $141,974 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $106,495 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $35,479 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,479 | TotalRevenueColumnAmt |
| Exclusion | $35,479 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $18,232,142 | SecuritiesAmt |
| Other | $1,200 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $19,324,406 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$1,092,264 | SecuritiesAmt |
| Other | $1,200 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,091,064 | TotalRevenueColumnAmt |
| Exclusion | -$1,091,064 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $1,878,920 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $1,911,049 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$32,129 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$29,155 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$2,974 | UnrelatedBusinessRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Income from K-1 | 541900 | $129,027 | $129,027 | |
| Other Income | 900099 | $43,345 | $43,345 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $172,372 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $185,020,732 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $184,595,880 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $126,053 | UnrelatedBusinessRevenueAmt |
| Exclusion | $298,539 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,642,111 | TotalAmt |
| Program Services | $50,173 | ProgramServicesAmt |
| Management And General | $2,591,938 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $706,250 | TotalAmt |
| Management And General | $706,250 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,595,196 | TotalAmt |
| Program Services | $57,608,640 | ProgramServicesAmt |
| Management And General | $1,986,556 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,116,372 | TotalAmt |
| Program Services | $1,996,026 | ProgramServicesAmt |
| Management And General | $120,346 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,443,475 | TotalAmt |
| Program Services | $15,392,200 | ProgramServicesAmt |
| Management And General | $1,051,275 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,659,368 | TotalAmt |
| Program Services | $5,322,689 | ProgramServicesAmt |
| Management And General | $336,679 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,249,772 | TotalAmt |
| Program Services | $2,325,039 | ProgramServicesAmt |
| Management And General | $924,733 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,505,623 | TotalAmt |
| Management And General | $1,505,623 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,466 | TotalAmt |
| Management And General | $293,466 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,533 | TotalAmt |
| Management And General | $103,533 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,890 | TotalAmt |
| Management And General | $46,890 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,723,148 | TotalAmt |
| Program Services | $19,607,078 | ProgramServicesAmt |
| Management And General | $4,116,070 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,304,698 | TotalAmt |
| Program Services | $28,805,875 | ProgramServicesAmt |
| Management And General | $498,823 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,408,090 | TotalAmt |
| Program Services | $8,408,090 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,624,547 | TotalAmt |
| Program Services | $1,504,584 | ProgramServicesAmt |
| Management And General | $119,963 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,813 | TotalAmt |
| Program Services | $35,300 | ProgramServicesAmt |
| Management And General | $72,513 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,775 | TotalAmt |
| Program Services | $112,952 | ProgramServicesAmt |
| Management And General | $30,823 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,892 | TotalAmt |
| Program Services | $86,892 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,970,383 | TotalAmt |
| Program Services | $7,970,383 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,224,066 | TotalAmt |
| Management And General | $1,224,066 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medi-cal Hospital Fee E | $14,549,983 | $14,549,983 | |
| Bad Debts Provision | $5,273,025 | $5,273,025 | |
| Dues & Subscriptions | $241,519 | $38,319 | $203,200 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,872 | TotalAmt |
| Management And General | $3,872 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $185,023,867 | TotalAmt |
| Program Services | $169,087,248 | ProgramServicesAmt |
| Management And General | $15,936,619 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,400 | BOYAmt |
| EOY | $3,901 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,119,095 | BOYAmt |
| EOY | $1,573,755 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,328,979 | BOYAmt |
| EOY | $33,783,195 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $894,878 | BOYAmt |
| EOY | $689,212 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,315,455 | BOYAmt |
| EOY | $3,184,513 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,302,000 | BOYAmt |
| EOY | $2,222,653 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $180,118,001 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $121,871,228 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,376,820 | BOYAmt |
| EOY | $58,246,773 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,114,742 | BOYAmt |
| EOY | $35,234,701 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,142,421 | BOYAmt |
| EOY | $5,244,467 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,604,606 | BOYAmt |
| EOY | $14,098,305 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,203,396 | BOYAmt |
| EOY | $154,281,475 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,890,532 | BOYAmt |
| EOY | $17,309,013 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $203,503 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,424,854 | BOYAmt |
| EOY | $1,961,338 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,172,383 | BOYAmt |
| EOY | $10,289,737 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,691,272 | BOYAmt |
| EOY | $29,560,088 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $123,174,007 | BOYAmt |
| EOY | $124,382,218 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,117 | BOYAmt |
| EOY | $339,169 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $123,512,124 | BOYAmt |
| EOY | $124,721,387 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,203,396 | BOYAmt |
| EOY | $154,281,475 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$3,135 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,212,398 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $103,533 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $103,533 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | DUES PAID TO CALIFORNIA HOSPITAL ASSOCIATION ARE CONSIDERED TO BE FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,268,040 | OtherCostOrOtherBasisAmt |
| Book Value | $4,268,040 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,995,756 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $79,840,272 | OtherCostOrOtherBasisAmt |
| Depreciation | $47,321,647 | DepreciationAmt |
| Book Value | $34,514,381 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,560,764 | OtherCostOrOtherBasisAmt |
| Depreciation | $999,365 | DepreciationAmt |
| Book Value | $561,399 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $84,944,337 | OtherCostOrOtherBasisAmt |
| Depreciation | $70,118,833 | DepreciationAmt |
| Book Value | $14,825,504 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,508,832 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,431,383 | DepreciationAmt |
| Book Value | $4,077,449 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $58,246,773 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Other Receivables | $2,078,161 |
| Cost Report Settlement Receivable | $10,816,108 |
| Deferred Compensation Fund | $898,314 |
| Accrued Interest on Investments | -$49,488 |
| Due from Medical Group | $355,210 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $14,098,305 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Risk Management Programs | $7,700,447 |
| Retiree Medical Liability | $2,589,290 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,289,737 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $182,921,491 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,212,397 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $2,012,149 | OtherRevenueAmt |
| Revenue Not Reported | $3,224,546 | RevenueNotReportedAmt |
| Revenue Subtotal | $179,696,945 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $46,890 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $5,276,897 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $5,323,787 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $185,020,732 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $181,712,229 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $2,012,149 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $2,012,149 | ExpensesNotReportedAmt |
| Expenses Subtotal | $179,700,080 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $46,890 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $5,276,897 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $5,323,787 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $185,023,867 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part XI, Line 2d - Other Adjustments: | Pharmacy Expenses netted against revenue on F/S 1,911,049. Rental Prop Depreciation netted against revenue on 990 101,100. |
| Part XI, Line 4b - Other Adjustments: | Provision for Bad Debts netted against revenue on F/S 5,273,025. Foundation Expenses netted against revenue on F/S 3,872. |
| Part XII, Line 2d - Other Adjustments: | Pharmacy Expenses netted against revenue on F/S 1,911,049. Rental Prop Depreciation netted against revenue on 990 101,100. |
| Part XII, Line 4b - Other Adjustments: | Provision for Bad Debts netted against revenue on F/S 5,273,025. Foundation Expenses netted against revenue on F/S 3,872. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 350.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,148,943 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,148,943 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $50,836,262 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $25,938,996 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $24,897,266 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13460 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $51,985,205 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $25,938,996 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,046,209 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14080 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $190,204 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $190,204 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,724 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,724 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $149,440 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $149,440 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $351,368 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $351,368 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $52,336,573 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $25,938,996 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,397,577 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14270 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $62,510 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $62,510 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $2,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $25,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $30,415 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $30,415 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $70,279 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $70,279 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $161,164 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $161,164 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $351,368 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $351,368 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,273,025 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $527,303 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $47,602,700 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $55,939,233 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$8,336,533 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dameron Hospital Association | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 West Acacia Street | AddressLine1Txt |
| City | Stockton | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.dameronhospital.org | WebsiteAddressTxt |
| State License | 030000024 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dameron Hospital Association | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.dameronhospital.org | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | www.healthiersanjoaquin.org | OtherWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.dameronhospital.org | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 350.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.dameronhospital.org | FAPAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.dameronhospital.org | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Dameron Hospital Association | Part V, Section B, Line 5: A community-based participatory research orientation was used to conduct the assessment, which included both primary and secondary data. Primary data collection included input from more than 180 members of the hospital service area (HSA), expert interviews with 45 key informants, and focus group interviews with 137 community members. Further input was gathered at meetings of the healthier community coalition and the annual community health forum, held in November 2012. In addition, a community health assets survey collected basic information for more than 300 assets in the greater San Joaquin County area.Secondary data included health outcome data, socio-demographic data, and behavioral and environmental data at the zip code or census tract level. Health outcome data included emergency department (ED) visits, hospitalization, and mortality rates related to heart disease, diabetes, stroke, hypertension, chronic obstructive pulmonary disease, asthma, and safety and mental health conditions. Socio-demographic data included race and ethnicity, poverty (female-headed households, families with children, people over 65 years of age), educational attainment, health insurance status, and housing arrangement (own or rent). Behavioral and environmental data such as crime rates, access to parks, availability of healthy food, and leading causes of death helped describe the general living conditions in the HSA. |
| Dameron Hospital Association | Part V, Section B, Line 6a: - St. Joseph's Medical Center- Lodi Memorial Hospital- Sutter Tracy Community Hospital- Kaiser Permanente |
| Dameron Hospital Association | Part V, Section B, Line 11: Working with other participants of the SJC2HAC Health Needs Assessment, Dameron concentrated on thethree primary health needs among the seven identified which most closely aligned with its mission and organizational capabilities. Dameron Hospital community benefit personnel then developed an implementation plan to address these needs. Although strategies to address the remaining four identified health needs were not included in the plan, Dameron will address these as secondary priorities through other hospital programs and activities. |
| Dameron Hospital Association | Part V, Section B, Line 13h: UNINSURED DISCOUNT. |
| Part V, Section B, Line 16 | Financial Assistance Policy Website Availability |
| Dameron Hospital Association Part V, Section B, line 16a website: | www.dameronhospital.org |
| Dameron Hospital Association Part V, Section B, line 16c website: | www.dameronhospital.org |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | The Bad Debt expense included on Form 990, Part IX, Line 25(A), but subtracted for purposes of calculating the percentage in this column is $5,273,025. |
| Part II, Community Building Activities: | * Community support- Dameron Hospital contributes to increasing health literacy by providing educational materials with pictorial and plain language information at all of our Community events and Health fairs.- "Books for Babies" is supported by our Volunteers who are associated with Tau Chapter of Delta Kappa Gamma (UOP Educators sorority). On a monthly basis,books are assembled both in English and Spanish. and a plentiful supply for all new mothers is available on the Mother Baby Unit. This service is associated with San Joaquin County Healthier Community Coalition, which focuses on increasing reading literacy in our community. Dameron Hospital supplies the books necessary to maintain this important program.- Free Interpreter Services for patients and their designated support person- Taxi/bus transportation to and from the Hospital/Clinic, if needed.* Leadership development and training for community membersLeadership Stockton is a program designed to inspire a new generation of men and women to assume leadership roles in the community. The nine-month program challenges and prepares individuals from diverse backgrounds to become influential in the region's future. To develop educated and motivated community leader participants are exposed to civic, civil, education, healthcare and non-profit entities. Participants heard from area healthcare leaders about the current and future state of healthcare. Michael Glasberg, Dameron Hospital's Chief Operating Officer and Vice-President of Operations, presented on behalf of Dameron Hospital. The roundtable discussion enabled participants to learn about hospital and healthcare facilities located throughout Greater Stockton community. A question and answer period concluded the forum.* Coalition buildingDameron Hospital is an active participant in the San Joaquin County Healthier Community Coalition. The purposes of the Coalition are: a) to provide leadership in the development and coordination of health status improvement efforts in San Joaquin County; b) to provide a forum for health services stakeholders to share ideas and information about projects and seek collaborative partners; and c) to work collaboratively and encourage the efforts of other collaborative attempting to respond to community health issues and problems. Currently we are collaborating on creating a 211 all inclusive help for all referral services. Dameron staff have co-chaired this Coalition and have participated in key leadership roles since 2011.*Community health improvement advocacyDameron has provided TB testing to Fire Department personnel, and has offered flu shot clinics in the community. In addition, Dameron's Linacia pharmacy has provided pharmaceuticals at no cost to a number of indigent patients.* Workforce developmentDecision Medicine is a two-week program, sponsored by San Joaquin Medical Society, is designed to introduce high school students to the field of medicine through personal mentoring opportunities and site visits with behind-the-scenes access to some of our regional hospitals, clinics and public health centers. Decision Medicine 2014 took place at various locations in Northern California, including hospitals, various clinics and inside actual private offices of participating physicians in San Joaquin County. Decision Medicine 2014 at Dameron Hospital was a full eight-hour day including student interactive tours into the Core Laboratory, the Pathology Laboratory, American Medical Response ambulance tour, and a tour of the Hospital Data Center; didactic lectures on Basic Hematology & Comparative Cellular Morphology and Forensic Pathology; and hands-on laboratory exercises for Phlebotomy, Blood Specimen Preparation, Blood Smear Technique, Differential Staining Technique, Blood Smear Examination by Light Microscopy, and Blood Typing. In addition, students were provided an individual Complete Blood Analysis (CBC), a preliminary ABO blood group determination, historical information about Dameron Hospital and career information in pathology and laboratory medicine. Twenty-seven students were hosted at Dameron Hospital which included lunch and refreshments throughout the day. The Director of Risk Management coordinates this Program for Dameron Hospital which includes a Board Member, the Chief Information Officer, a Hospital Administrator, the Laboratory Medical Director, the Laboratory Manager, several Clinical Laboratory Scientists, the Patient Relations Coordinator, and the Employee Relations Coordinator. Also, Dameron Hospital entered into an agreement whereby the Hospital has extended an income guarantee to a physician in exchange for the doctor providing services in the Hospital's service area. Payments under the guarantee began being forgiven in August of 2012 and continued over 24 months. The payments forgiven in 2014 amounted to $59,765.* Other community building activityDameron Hospital is accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA) to provide Continuing Medical Education for physicians. Classes are offered at noon on Fridays (excluding Holidays and the months of July and August) in the hospital's Annex building. The classes are open to all physicians throughout the community. Dameron provided 25 continuing medical education classes throughout 2014 and will continue to provide Continuing Medical Education Classes in 2015. A total of 786 medical professionals attended the classes in 2014; and 140 other healthcare professionals. Dameron Hospital also provides staff, volunteer time, and meeting room space for community programs and organizations throughout San Joaquin County:- NICU and Bariatric support groups- US Coast Guard Coalition- Healthier Community Coalition- Alpha Phi Chapter of Chi Eta Phi Nursing Society - Health and Wellness Family Festival at Lodi Lake- ACNL- Flu Shot Clinics- Narcotic Anonymous- TB tests Stockton Fire Dept.- AAUW (Am Assoc of University Women)- Champions for Change: Network for a Healthy California- Lamaze Prepared Childbirth- Chi Eta Phi Sorority Meeting - The Record's Literacy and Book Fair - Family Fun Day in the Park - Healthy Highway- Healthy Lifestyles - No. California Stroke Coord. Meeting - California Emergency HAM volunteers- NICU Support Group- Decision Medicine- Bariatric Support Group- Breastfeeding Coalition- California Society for Healthcare Engineering |
| Part III, Line 4: | The organization determines the amount that could be attributable to patients who likely would qualify for financial assistance under the hospital's financial assistance policy based upon a query of the collections system (Golden State Collections) - 10% of estimated bad debt expense.Any discounts and/or payments applied to a patient's account are not reversed before writing the account off to bad debt. In other words, the net balance of the account is what's written off.Bad debt expense is not included as a community benefit in the hospital's community benefit report.Bad Debt expense footnote - See audited financial statements, page 5, footnote 1, Patient accounts receivable and Allowance for uncollectible accounts sections. |
| Part III, Line 8: | If Medicare does not reimburse our costs for patient care, the excess of cost over reimbursement should be considered a benefit to the community we serve.Medicare uses the Medicare cost report program in computing the cost in providing medical care services for Medicare beneficiaries. The Medicare cost report calculates routine costs using per diem methodolgy and the ancillary cost is calculated using cost to charge ratios. |
| Part III, Line 9b: | The account automatically sets a follow-up date for the collector to work. When the collector works the account, the collector determines the collectibility of the account. This can be determined through contact with the patient, patient's personal financial statement, employment status, CBI credit reports, property listings, skip tracing, etc. |
| Part VI, Line 2: | Dameron Hospital is a member of the San Joaquin County Community Health Assessment Collaborative (SJC2HAC), which is responsible for producing and releasing, every three years, the Healthier San Joaquin County Community Assessment. Federal and state laws require that not-for-profit hospitals conduct a Community Health Needs Assessment (CHNA) every three years. Based on the results of this assessment, an implementation Plan is developed detailing how the community needs will be addressed. This plan is submitted annually to both the California Office of Statewide Health Planning and Development (OSHPD) and the Internal Revenue Service. In accordance with these legislative requirements, Dameron Hospital, in collaboration with other members of The (SJC2HAC) conducted an assessment of the community they serve, which encompasses all of San Joaquin County. The CHNA was conducted over eight-months and was led by Valley Vision, Inc., a non-profit community consulting organization dedicated to improving the quality of life for residents across Northern California. The most recent SJC2HAC assessment was released in March 2013. The assessment is used to: inform and engage local stakeholders and community members, promote collaborative efforts based on data, solicit community input and obtain group consensus in order to improve the health of our community. |
| Part VI, Line 3: | Dameron Hospital encourages its uninsured and partially insured patients to apply for financial assistance programs. A financial counselor is available on site to assist patients through the process of determining programs for which they may qualify. Signage in English and Spanish is posted in the hospital registration areas to provide patients with financial assistance program information. The financial counselor provides assistance with programs such as MediCal, Victims of Crime, Hospital Uninsured Discount, Hospital Charity and County MIAP, etc. |
| Part VI, Line 4: | San Joaquin County is one of the original counties of California, created in 1850 and is located in the Central Valley of Northern California; home to approximately 700,000 residents. The County seat is Stockton, the largest incorporated city in the county and is home to almost half of the county's residents. San Joaquin has a rich agricultural presence and is known for its asparagus, strawberries, almonds, cherries, and other abundant crops. The racial and ethnic makeup of county residents includes Whites (68.7%), African American (8.2%), and Native American 2.0%), Asian (15.5%), Pacific Islander (0.7%), and two or more races (4.9%). Hispanic or Latino origin includes (39.4%). According to the US Census (2011), almost 40% of all county residents speak a language other than English at home, and nearly one in four over the age of 25 does not have a high school diploma. San Joaquin County offers its residents affordable housing, abundant recreational facilities, excellent educational opportunities, and diverse cultural resources. As the northernmost county in the Central Valley, San Joaquin County includes the cities of Stockton, Lathrop, Lodi, Manteca, Ripon, Tracy, and Escalon, as well as numerous planned communities, census-designated areas, small towns and unincorporated areas. The U.S Census Bureau anticipates that San Joaquin County's population will reach 789,000 by 2020. Population change by ethnicity will also affect San Joaquin County; the largest increase over the next thirty years will come from an estimated 104.6% increase in the Hispanic/Latino population and the white population will decrease by 8.7%. This represents a significant shift in San Joaquin County demographics. In 2013, unemployment for the county was 14.4% compared to the state rate of 10.1%. San Joaquin County earned a nation-wide reputation for its high number of home foreclosures; in 2013, 22% of all homes were in some stage of foreclosure compared to the state rate of 14% and national rate of 12%. According to the U.S. Department of Urban Housing and Development (HUD), San Joaquin County's median household income has increased 39% over the last decade, reaching $63,100 in 2010; despite this increase, the County's median household income was lower than the median household income in the United States ($64,000), and in California ($71,000). It is important to note that a greater percentage of the San Joaquin County population lives below federal poverty levels compared to the rest of the state of California. HUD projected that San Joaquin County's 2012 median household income was $66,300. The 2010 Census showed that people aged 60 and older now make up 15% of the population. The 2010 Census also shows people under the age of 20 has decreased to 32.9%. The percentage of the youth population ages 6-17 are projected to remain nearly constant from 2010 to 2020, while the percentage for those ages 0-5 are projected to increase.10 Adults aged 19 and older will increase by 31% by the year 2040. These trends show that San Joaquin County's population is slowly aging. |
| Part VI, Line 5: | In addition to the medical services and programs we offer, Dameron Hospital also offers the following community benefits and outreach services:- Classroom use for community education and support groups- A program for adults to volunteer their time in a health care environment- Sponsorship of health-related community events and activities- Donations of materials, equipment and supplies to community groups- Employee volunteer time- Transportation- Continuing medical education for community physicians- Community education classes- Diabetic outpatient education program- Unreimbursed Medi-Cal, Medicare, and charity care- Uninsured patient discount- Participation in a program exposing high school students to health care careers to encourage youth to give back to the community and consider a career in medicine (Decision Medicine)- Free wireless internet access- Workforce development- Hospitalist program for inpatients admitted through Dameron Hospital Emergency Room who do not have a primary care physician- Health professional education- Management staff participation in local leadership programs- An online health center- Management participation in local school mentoring programs- Physician recruitment in a medical shortage area- Staff participation in conducting community health needs assessments- Multilingual education classes- Junior volunteers- A variety of support groups- Providing a clinical setting for undergraduate/vocational training to students enrolled in an outside organization- Notary Services- Interpreter Services for patients and their support person- Taxi Transportation for patients as needed |
| Part VI, Line 6: | (not part of affiliated healthcare system) |
| Part VI, Line 7, Reports Filed With States | CA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lorraine Auerbach | ||||||||||||||
| President/CEO | $697,853 | $0 | $234,441 | $0 | $0 | $0 | $0 | $0 | $10,303 | $0 | $942,597 | $0 | $0 | $0 |
| Elizabeth Propp | ||||||||||||||
| VP of Finance, CFO | $299,837 | $0 | $93,402 | $0 | $0 | $0 | $0 | $0 | $6,840 | $0 | $400,079 | $0 | $0 | $0 |
| Michael Glasberg | ||||||||||||||
| VP of Operations, COO | $308,079 | $0 | $42,234 | $0 | $0 | $0 | $0 | $0 | $5,459 | $0 | $355,772 | $0 | $0 | $0 |
| Janine Hawkins | ||||||||||||||
| VP of Patient Care Services, CNO | $297,356 | $0 | $0 | $0 | $50,000 | $0 | $13,825 | $0 | $10,292 | $0 | $371,473 | $0 | $50,000 | $0 |
| David Kerrins | ||||||||||||||
| VP of Information Services, CIO | $237,844 | $0 | $40,411 | $0 | $0 | $0 | $0 | $0 | $10,335 | $0 | $288,590 | $0 | $0 | $0 |
| Bradley Reinke | ||||||||||||||
| VP of Medical Affairs, CMO | $259,600 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $259,600 | $0 | $0 | $0 |
| William Chase | ||||||||||||||
| Director of Finance (Through 4/2014) | $132,863 | $0 | $0 | $0 | $150,000 | $0 | $2,618 | $0 | $2,881 | $0 | $288,362 | $0 | $150,000 | $0 |
| Chad Davis | ||||||||||||||
| RN Manager - Surgery | $229,257 | $0 | $0 | $0 | $0 | $0 | $7,512 | $0 | $5,487 | $0 | $242,256 | $0 | $0 | $0 |
| Terrance Thomas | ||||||||||||||
| Registered Nurse | $218,566 | $0 | $0 | $0 | $0 | $0 | $7,810 | $0 | $9,409 | $0 | $235,785 | $0 | $0 | $0 |
| Shawn Fillon | ||||||||||||||
| Registered Nurse | $202,147 | $0 | $0 | $0 | $0 | $0 | $6,229 | $0 | $5,615 | $0 | $213,991 | $0 | $0 | $0 |
| Maria Villarreal | ||||||||||||||
| Assistant Nurse Manager | $188,375 | $0 | $0 | $0 | $0 | $0 | $7,593 | $0 | $9,053 | $0 | $205,021 | $0 | $0 | $0 |
| Christopher Arismendi | ||||||||||||||
| Former CEO (Through 10/2012) | $0 | $0 | $0 | $0 | $300,000 | $0 | $0 | $0 | $0 | $0 | $300,000 | $0 | $0 | $0 |
| Cyrus Dah | ||||||||||||||
| Former CFO (Through 12/2012) | $0 | $0 | $0 | $0 | $162,500 | $0 | $0 | $0 | $0 | $0 | $162,500 | $0 | $0 | $0 |
| Nicholas Arismendi | ||||||||||||||
| Former COO (Through 7/2013) | $0 | $0 | $0 | $0 | $243,750 | $0 | $0 | $0 | $0 | $0 | $243,750 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Lines 4a-b | Dr. Christopher Arismendi terminated as CEO/President on 10/31/12. His severance agreement is for a total of $1,200,000 over 4 years, and during 2014 a total of $300,000 was paid to him. Cyrus Dah terminated as CFO on 12/31/12. His severance agreement is for a total of $325,000 over 2 years, and during 2014 a total of $162,500 was paid to him. Nicholas Arismendi terminated as COO on 7/8/2013. His severance agreement is for a total of $375,000 over 18 months, and during 2014 a total of $243,750 was paid to him. William Chase terminated as Controller on 3/19/14. His severance agreement is for a total of $230,000 over 18 months, and as of 12/31/14 no severance payments had yet been made to him. The 457(f) plan was open to highly compensated executive or managerial personnel determined to be eligible by the plan committee. During 2014 there were two remaining participants, one of whom (William Chase) terminated early in the year. The plan indicates that participants may defer up to 100% of their compensation under the plan. Amounts reported in Part II, Column (B)(III) are distributions of prior year 457(f) contributions. |
| Part I, Line 7 | Executive Incentive Compensation is set based on meeting a specific set of metrics established annually by the CEO and Executive Team and approved by the Board. Metrics generally include quality, finance, patient safety, patient experience, employee engagement and meaningful use goals. Each year, the Board appoints an Executive Compensation Committee to 1) review and approve an Annual Executive Compensation Plan; 2) to evaluate Executive performance against established goals as well as overall executive performance; and 3) to set the overall Executive Compensation Plan for the following year. The CEO provides recommendations concerning the performance and compensation of the Executives for Board approval. The Executive Compensation Committee and Chairman of the Board evaluate the CEO and approve the CEO's compensation. The Annual Executive Compensation Plan is developed and presented to the Board by an independent healthcare compensation expert who also advises and guides the board as to market and other factors affecting executive and CEO compensation. This includes but is not limited to base compensation, the Executive Incentive program and recommended performance and market compensation adjustments. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11 | Form 990 is reviewed by the CFO, Director of Finance, and Accounting Supervisor. The return is provided to the board for review prior to filing. |
| Form 990, Part VI, Section B, line 12c | Each individual Fiduciary must execute a Conflicts of Interest Disclosure Statement and Questionnaire at least annually and must promptly report all facts regarding any new transaction that might create a Conflict of Interest as soon as they become aware of any such transaction. It is each Fiduciary's duty to make a full disclosure as provided herein of all material facts regarding any possible conflict of interest, to describe the situation or transaction, and to disclose the details of the employee, medical staff officer, or Related Party's interest in the situation or transaction. All Fiduciaries shall report all possible conflict of interest to the Chief Executive Officer, or his designee. The Chief Executive Officer, or designee, shall conduct such review as appropriate, and refer such information to the Governance Committee of the Hospital. The Governance Committee shall review such conflicts and disclosures and, at least annually, shall report any material conflicts to the Board, along with recommendations, if any, with respect to such persons or conflicts. The Board or Governance Committee may consult with legal counsel and such other authorities as may be desired, and may request any additional information deemed relevant, including the source and amount of any income or financial interest or other economic benefit to be derived by such person from the situation or transaction. It is the policy of the Board of Directors that the existence of ANY interest shall be disclosed before any transaction is consummated. Each Fiduciary has a continuing responsibility to scrutinize any transaction in which the Fiduciary or a Related Party is directly or indirectly interested for potential conflict of interest and to make a full disclosure as provided herein. The Chief Executive Officer, the Governance Committee or the Board of Directors shall as provided herein then determine whether a Conflict of Interest exists and shall take the appropriate action. All decisions regarding conflicts of interest rest in the sole discretion of the Board of Directors in the exercise of its ultimate judgment of the best interests of the Hospital. |
| Form 990, Part VI, Section B, line 15 | In 2013 the organization established an executive compensation committee, which sets the policy each year and creates the compensation document. An outside independent consultant, Romanoff & Associates, provides salary ranges and market value used in setting compensation. |
| Form 990, Part VI, Section C, line 19 | Financial statements are made available upon request. Governing documents and conflict of interest policy are not available to the public to view. |
| Form 990, Part IX, line 11g | Nurse Registry: Program service expenses 3,101,550. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,101,550. Other Contracted Services: Program service expenses 1,721,500. Management and general expenses 365,075. Fundraising expenses 0. Total expenses 2,086,575. Physicians Fees: Program service expenses 2,883,332. Management and general expenses 5,850. Fundraising expenses 0. Total expenses 2,889,182. Other Professional Fees: Program service expenses 88,239. Management and general expenses 102,616. Fundraising expenses 0. Total expenses 190,855. Pharmacy and Laboratory Outsourcing: Program service expenses 4,790,916. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,790,916. Maintenance: Program service expenses 1,977,897. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,977,897. Medical records & Transcription services: Program service expenses 0. Management and general expenses 1,875,920. Fundraising expenses 0. Total expenses 1,875,920. Dialysis services: Program service expenses 763,625. Management and general expenses 0. Fundraising expenses 0. Total expenses 763,625. Collection services: Program service expenses 577,046. Management and general expenses 0. Fundraising expenses 0. Total expenses 577,046. Contract negotiation assistance: Program service expenses 862,721. Management and general expenses 0. Fundraising expenses 0. Total expenses 862,721. Other Purchased Services: Program service expenses 2,840,252. Management and general expenses 1,766,609. Fundraising expenses 0. Total expenses 4,606,861. |